23. Hallux Rigidus

Hallux rigidus should be regarded as comprising two arthrosic components, one affecting the metatarsophalangeal joint of the great toe, the other the associated metatarsosesamoidal joints. Osteophyte formation and progressive ankylosis involve both sites. The whole foot becomes affected, including integument, muscles and ligaments. The skin loses its normal suppleness and thickness, and there is a reduced amount of local subcutaneous fat. The atrophic capsule becomes greyish in colour and rigid, and is closely moulded to the underlying distorted bone configuration. The capsule rarely hypertrophies, but occasionally some thickened fibres with yellowish concretions are formed within it. Marked atrophy of abductor hallucis and flexor hallucis longus is seen.